First of all, our tremendous thanks to Chris Scheumann for coming in and helping us with this episode. For those of you who don’t know Chris, he is is possibly one of the most down to earth and approachable guys we have had the chance to get to know over the last year with this podcast. He is the Trauma Outreach Coordinator at Parkview Regional Medical Center in Fort Wayne, IN, and has been involved in EMS since the early 90s. I don’t know many people regionally that haven’t been affected by him in some capacity or another. Thanks, Chris, for being a true local resuscitationist.

Today, we are going to be talking about pelvic trauma. I know what many people’s reactions to this topic are. Groan. Pelvic trauma isn’t portrayed as a sexy injury type, but it is commonly one of the most missed by prehospital providers and emergency departments, and can have fatal consequences. So let’s get to it.

TYPES OF PELVIC FRACTURES

Lateral compression fractures

Pedestrian vs Car MVCs

T-Bone MVCs

Anteroposterior compression fractures

Head-on MVCs

Crush injuries

Vertical shear fractures

High falls

ASSESSMENT TECHNIQUES

DO NOT rock the pelvis

DO NOT apply posterior pressure

Attempt to assess with medial pressure

Once you feel instability, DON’T LET GO

This is not a type of injury you want the student to assess

Shortening and rotation of lower extremity does not JUST indicate a hip fracture, but could show some degree of pelvic instability

Remember that the pelvic girdle can hold upwards of 1.5L of blood; pelvic fracture can exanguinate into the retroperitoneal space as well.

WHY DO WE SPLINT THE PELVIS?

Decreases amount of volume pelvis can hold

Reduces instability of the broken pelvis

Pain reduction by limited mobility of pelvis

Contrary to popular belief, splinting alone does not tamponade pelvic bleeding